Individual
CLINTONARY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5428 COUNTRY CLUB LN, GRAND BLANC, MI 48439-9179
(810) 308-1056
Mailing address
5428 COUNTRY CLUB LN, GRAND BLANC, MI 48439-9179
(810) 308-1056
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703091879
MI
Other
Enumeration date
03/27/2016
Last updated
03/27/2016
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